Last updated: February 14, 2026
Overview
NDC 25021-0132 corresponds to EMEND (fosaprepitant dimeglumine) for intravenous use. It is an antiemetic used primarily to prevent chemotherapy-induced nausea and vomiting. The drug, marketed by Merck & Co., gained approval in December 2011, with subsequent expansions for broader oncology indications. Key market segments include oncology hospitals, outpatient infusion centers, and chemotherapy clinics.
Market Size and Growth Drivers
The global antiemetic market was valued at approximately $1.7 billion in 2022. It is projected to grow at a compound annual growth rate (CAGR) of around 5-6% through 2030, driven by increasing cancer incidence, expanding indications for antiemetics, and the adoption of advanced chemotherapy protocols.
Major growth drivers include:
- Rising cancer prevalence in North America and Asia-Pacific
- Adoption of combination antiemetic regimens including NK1 receptor antagonists like fosaprepitant
- Expansion of indications beyond chemotherapy to radiation therapy-associated nausea
Market Share and Competitive Landscape
NDC 25021-0132 faces competition primarily from:
- PO formulations of fosaprepitant (e.g., Emend IV)
- Other NK1 receptor antagonists like aprepitant (oral) and rolapitant
- 5HT3 antagonists and corticosteroids as adjuncts
Market share remains concentrated among large hospital systems and oncology clinics. The drug's utilization depends heavily on institutional formulary decisions and reimbursement policies.
Pricing Analysis
The wholesale acquisition cost (WAC) for a single 150 mg dose of fosaprepitant (NDC 25021-0132) as of 2022-2023 has been approximately $210-$230 per dose. This compares to:
| Specification |
Price Range (USD) |
Notes |
| WAC |
$210 - $230 |
Per single dose (150 mg) |
| Average Selling Price |
$180 - $200 |
Estimated, varies by distributor |
| Reimbursement rates |
Similar to WAC + 10-15% |
Payment through Medicare, Medicaid, private insurers |
Pricing trends indicate slight reductions in list prices over the past two years, driven by payer negotiations and increasing generic competition for related formulations.
Price Forecasts (2023-2030)
Considering market trends, the following projections are modeled:
- Baseline scenario: Maintaining current WAC with minimal discounts, price remains stable at ~$220 per dose through 2025.
- Downward pressure scenario: Increasing generic competition and formulary shifts lead to a 3-5% annual price decrease; prices fall to ~$180-$190 by 2027.
- Upside scenario: New indications or improved formulations could sustain or slightly increase prices, reaching ~$230-$240 per dose by 2030.
Overall, the average price per dose is projected to decline modestly by 2-3% annually, aligning with typical antiemetic market trends.
Reimbursement and Cost Dynamics
Insurance reimbursement varies by payer and setting. Medicare Part B covers intravenous drugs at rates tied to the Medicare Physician Fee Schedule, with additional costs passed to institutions. Payer negotiations and formulary placements influence actual net prices, which are typically below WAC.
Regulatory and Policy Impacts
Policy shifts favoring biosimilars and generics could further pressure prices. The FDA has approved several biosimilar oncology agents; although none currently target fosaprepitant directly, the trend toward biosimilar adoption affects the entire class.
Key Takeaways
- NDC 25021-0132 (emend fosaprepitant IV) operates in a growing antiemetic market driven by cancer treatment expansion.
- Current pricing is around $210-$230 per dose; forecasts suggest slight declines over the next five years.
- Market share is concentrated among large hospitals and oncology centers, with increasing generic and biosimilar competition exerting downward price pressure.
- Reimbursement policies and formulary decisions significantly influence net revenue per unit.
- Future pricing will depend on market penetration, competitive pressure, and potential new indications or formulations.
FAQs
1. What factors influence the price of NDC 25021-0132?
Reimbursement policies, payer negotiations, competition from generics or biosimilars, and hospital formulary decisions primarily impact the price.
2. How does market growth impact pricing?
Market growth increases volume but exerts downward pressure on unit prices due to economies of scale and competitive dynamics.
3. What is the likelihood of biosimilar entry affecting prices?
While no biosimilars target fosaprepitant directly, biosimilar introductions in similar classes have historically reduced prices and may do so indirectly through market competition.
4. What are the main obstacles to price increases?
Increased generic competition, stricter reimbursement policies, and the availability of cheaper alternatives prevent significant price hikes.
5. How does the oncology market influence product adoption?
The expanding oncology market, driven by higher cancer prevalence and evolving treatment protocols, increases demand, supporting stable or slightly higher prices.
Sources
[1] IQVIA, "Global Oncology Market Data," 2022.
[2] Medicare Payment Advisory Commission (MedPAC), "Payment Policies for Oncology Drugs," 2022.
[3] EvaluatePharma, "Anti-emetics Market Report," 2023.
[4] FDA Approvals, "Biosimilar and Generic Approvals," 2022.
[5] Industry interviews and pricing reports, 2023.
